Menstruation
and menopause
can be problematic for all women, but for those with Parkinson’s they may
present additional challenges. Unfortunately this is an area that has received
little recognition in the past although far more attention is now being paid to
this important subject and research is under way to evaluate treatments.
Menstruation
It has been suggested that as many as 11 out of 12 pre-menopausal women with
Parkinson’s experience a worsening of their symptoms and reduced effectiveness
of their medications a few days before (Premenstrual Syndrome – PMS) and during
menstruation1, particularly tremor, dyskinesia
and rigidity.
Treating PMS is generally the first line of approach but you may find it
helpful to discuss this with your neurologist too as in some cases it seems
that taking additional Parkinson’s medications during this part of the monthly
cycle can help.
Moreover research has revealed that many women suffer increased menstruation
problems following the onset of Parkinson’s, in particular more bleeding and
associated pain. Women have also expressed concern regarding their changing
body image; some felt unattractive and changed their dressing style to cope
better with their symptoms, and others described feeling a sense of loss1.
Using sanitary products can be particularly difficult if your symptoms are
not well controlled. You may find it helpful to time it so that you change them
when you are ‘on’ and have good control.
If menstrual problems are severe then medication such as Danazol can be used
to suppress ovulation, although there are possible side effects such as
sweating and worsening of Parkinson’s symptoms.
Medication does not always help and if problems are severe then the
following options might be available to you:
- hormone therapy using a
combination of oestrogen and progesterone to suppress ovulation
- surgery, including removal
of the lining of the womb or hysterectomy
- radiotherapy of the ovaries
to induce a premature menopause.
These can all have side effects - hot flushes, for example - but women are
all affected differently so what works for one person may or may not work for
another.
Menopause
Menopause can affect sexual desire and function in every woman and quite
often these changes occur around the time that Parkinson’s is diagnosed. For
some, menopausal symptoms such as sweating can exacerbate symptoms so it might
be necessary to involve a gynaecologist or other women’s health professional.
There can also be confusion between the symptoms of menopause and Parkinson’s –
fatigue, depression and increased sweating for example can occur in both
conditions.
As with menstrual problems, Hormone Replacement Therapy (HRT) can be helpful
in some cases although research and evidence into its use in Parkinson’s is
rather limited. Again, you may need to involve a gynaecologist or other women’s
health professional and make sure that they liaise with your specialist so that
both conditions are treated effectively.
If you experience vaginal dryness, which is a common sign of menopause, ask
your doctor about the use of a vaginal HRT as this may be more helpful than an
ordinary lubricant.
